The Complete Guide to Herbal Medicines

The first clinically accurate guide that's free of new-age hype and created expressly for the nonprofessional! Readers learn about more than 300 herbal medicines, including an overview, traditional and current uses, common doses, side effects, interactions, and current research findings. Also includes a glossary and nonherbal remedies. Convenient A-to-Z organization. Written by the authors of Springhouse's best-selling Professional's Handbook of Complementary & Alternative Medicines

From Chapter 1: Understanding and Using Herbal Medicines

Most people are familiar with herbs as foods -- for example, basil and oregano in sauces, parsley as a garnish. However, for thousands of years many cultures around the world have used herbs and plants not just to eat but to treat illness. Archaeological evidence shows that even prehistoric man used plants to heal. Today, the World Health Orgamization estimates that 80ő of the world's population uses some form of herbal medicine.

Many of the drugs now prescribed come from plants that ancient cultures used medicinally. (The word drug comes from the Old Dutch word drogge, meaning "to dry," because pharmacists, doctors, and ancient healers often dried plants to use as medicines.) About one-fourth of all conventional pharmaceuticals -- including roughly 120 of the most commonly prescribed modem drugs -- contain at least one active ingredient derived from plants. The rest are chemically synthesized. (See Common drugs made from plants.)

Common drugs made from plants

Many drugs in common use today have botanical origins. Here's a selected list.

* Aspirin (salicylic acid) -- from white willow bark and meadow sweet plant

* Atropine, used to treat irregular heartbeat -- from belladonna leaves

* Colchicine, used for gout -- from autumn crocus

* Digoxin (Lanoxin), the most widely prescribed heart medication -- from foxglove, a poisonous plant

* Ephedrine, used to widen or relax the airways -- from the ephedra plant

* Morphine and codeine, potent narcotics -- from the opium poppy Paclitaxel Taxol), used to treat metastatic ovarian cancer -- from the yew tree

* Quinine, a drug for malaria -- from cinchona bark

* Vinblastine (Velban) and vincristine (Oncovin), anticancer drugs -- from periwinkle

Potentially dangerous herbs

Herbs can harm as well as heal. The herbs below may pose special risks.

* Bloodroot, promoted as an expectorant purgative, stimulant and plaque and cavity preventer, is used in such a range of doses that it can be dangerous. It has caused death when used to induce vomiting.

* Chan su, a topical aphrodisiac also known as stone, love stone, and rockhard, has been fatal when mistakenly ingested.

* Chaparral tea, claimed to be an antioxidant and pain reliever, has caused liver failure, necessitating liver transplantation.

* Coltsfoot, used for respiratory problem has caused liver problems.

* Comfrey, used to promote wound healing (and formerly to relieve ulcers of the bowel, stomach, liver, and gallbladder), has caused liver problems and cancer.

* Indian herbal tonics can lead to lead poisoning.

* Jin bu huan, an ancient Chinese sedative and analgesic, contains morphine-like substances and has caused hepatitis.

* Kambucha tea, made from mushroom cultures and used as a cure-all, has caused death from a blood acid disorder.

* Lobelia, used to treat respiratory congestion, has led to respiratory paralysis and death.

* Ma huang, or ephedra, an ingredient in many diet pills, can cause psychotic behavior, seizures, irregular heartbeats, heart attack, stroke, and death. It's also sold under such names as Herbal Ecstasy, Cloud 9, and Ultimate Xphoria to induce a 'high' associated with illegal drugs.

* Pennyroyal, used to induce menstruation and treat colds, fevers, and the flu, has caused liver failure, kidney failure, coma, and death.

* Sassafras, used as a diuretic and a treatment for skin disorders and rheumatism, has caused liver damage. It has also been linked to narcotic poisoning and miscarriage. The Food and Drug Administration has banned sassafras volatile oil and the component safrole as food additives and flavor enhancers.

* Yohimbe bark, used as an aphrodisiac and hallucinogen, has caused psychotic behavior.

Misleading claims

The herbs below have been misrepresented as cures for serious illnesses.

* Mistletoe has been falsely touted as a cure for cancer.

* Pau d'Arco tea has been falsely touted as a cure for cancer and AIDS.

Some herbs and plants have value not just for their active ingredients but for other substances they contain, such as:

* minerals

* vitamins

* volatile oils (used in aromatherapy)

* glycosides (sugar derivatives)

* allkaloids (bitter organic bases containing nitrogen)

* bioflavonoids (colorless substances that help maintain collagen and blood vessels).

In the United States, many traditional health care providers lack knowledge about herbal remedies, and their patients may be reluctant to reveal their use of such remedies. But renewed interest in all forms of alternative medicine has led consumers, health care providers, and drug researchers to reexamine herbal remedies. Medicinal herbs have been touted in magazines, books, and television shows, sometimes with advocates making amazing claims for their benefits.

Unfortunately, herbs don't have magical or mystical properties. Like all drugs, they must be taken in the right doses for the right length of time-and for the right purpose -- to produce a benefit. While some herbs are safe and effective, others can cause lasting harm and even death. (See Potentially dangerous herbs.)

Still other herbs are neither harmful nor effective.

History of herbal medicine

Herbal medicine, also called phytotherapy or phytomedicine, has been practiced since the beginning of recorded history. Specific remedies have been handed down from generation to generation.

In ancient times, medicinal plants were chosen for their color or the shape of their leaves. For example, heart-shaped leaves were used for heart problems, while plants with red flowers were used to treat bleeding disorders. This primitive approach is called the Doctrine of Signatures. Practitioners determined the best use for each plant by trial and error.

The formal study of herbs, called herbology, dates back to the ancient cultures of the Middle East, Greece, China, and India. These cultures revered the power of nature and developed herbal remedies based on the plants found in their home environments. Written evidence of the medicinal use of herbs has been found on Mesopotamian clay tablets and ancient Egyptian papyrus.

The first known compilation of herbal remedies was ordered by the king of Sumeria around 2000 B.C. and included 250 medicinal substances, including garlic. Ancient Greece and Rome produced their own compilations, including De Materia Medica, written in the I 1st century A.D. Of the 950 medicinal products described in this work, 600 come from plants and the rest from animal or mineral sources.

The Arabs added their own discoveries to the Greco-Roman texts, resulting in a compilation of more than 2,000 substances. Eventually, this work was reintroduced to Europe by Christian doctors traveling with the Crusaders. Herbal therapy is also a major component of India's Ayurvedic medicine, traditional Chinese medicine, Native American medicine, homeopathy, and naturopathy.

In the United States, herbal remedies handed down from European settlers and learned from Native Americans were a mainstay of medical care until the early 1900s. The rise of technology and the biomedical approach to health care eventually led to the decline of herbal medicine.

The herbal revival that we're seeing today has several causes:

* general disillusionment with modern medicine

* the high cost and side effects of prescription drugs

* widespread availability of herbal medicines

* the belief that natural remedies are superior to manmade drugs.

Regulating herbal medicine

In the 19th century, many fake remedies were sold to gullible, desperate Americans. The federal government finally took action against disreputable purveyors of phony remedies by passing the Food and Drug Act of 1906. This law addressed problems of mislabeling and adulteration of plant remedies -- but not safety and effectiveness.

Today, herbal remedies remain largely unregulated. The Food and Drug Administration (FDA) regulates herbal products only as dietary supplements, not drugs. This means that the FDA can recall herbal products that are shown to be harmful, but manufacturers aren't required to provide information about their products' contents or side effects or to prove their safety or efficacy. They need only provide "reasonable assurance" that the product contains no harmful ingredients.

What's more, although manufacturers can't claim a particular product cures or prevents a specific disease, they can make any other claim about the supposed benefits without providing supporting evidence. They need only add the following disclaimer: "This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure or prevent any disease."

In essence, herbal remedies in the United States are sold on a buyer-beware basis. This highlights the importance of learning everything you can about any herbal products you plan to use.

European standards

In Europe, where millions of people use herbal and homeopathic remedies, governments and the scientific community are much more open to natural remedies, especially those with a long history of use. In Great Britain and France, traditional medicines that have been used for years with no serious side effects are approved for use under the "doctrine of reasonable certainty" when scientific evidence is lacking.

The European Economic Community has established guidelines that standardize the quality, dosage, and production of herbal remedies. These guidelines are based on the World Health Organization's Guidelines for the Assessment of Herbal Medicines, a 1991 publication that addressed concerns about the safety and effectiveness of herbal medicines.

Therapeutic uses of herbs

A plant's leaves, flowers, stems, berries, seeds, fruit, bark, roots, or any other part may be used for medicinal purposes. Most herbal remedies are used to treat minor health problems, such as nausea, colds, cough, flu, headache, aches and pains, stomach and intestinal disorders (such as constipation and diarrhea), menstrual cramps, insomnia, skin disorders, and dandruff.

Some herbalists have reported success in treating certain chronic conditions, including peptic ulcers, inflammation of the colon, rheumatoid arthritis, high blood pressure, and respiratory problems. Some use herbal remedies for illnesses usually treated only with prescription drugs, such as heart failure.

However, if you have a serious disorder and are considering an herbal remedy, don't discontinue ongoing medical treatment. Also be sure to tell your health care practitioner about any prescribed drugs you're taking, because these may interact with herbal remedies. (See Taking herbal remedies safely, pages 6 and 7.)

Research on herbal remedies

Numerous studies on herbal remedies have been done in Europe and Asia. European studies have shown benefits from such herbs as ginkgo, bilberry extract, and milk thistle in treating various chronic disorders. Chinese researchers have extensively studied many herbs, such as ginseng, fresh ginger rhizome, foxglove, licorice root, and wild chrysanthemum. Indian researchers using modem scientific methods have recently studied various Ayurvedic, herbs, including Indian gooseberry and turmeric.

Taking herbal remedies safely

Many people take for granted the safety of the drugs and foods they buy. But unlike drugs, herbal remedies aren't reviewed by any government agency for quality, dosage, safety, or efficacy. If you're thinking about taking an herb, know that the vast majority of botanical products sold in the United States haven't been scientifically tested. Their alleged benefits are based largely on word-of-mouth.

How herbal products are regulated

The Food and Drug Administration regulates herbal products as food supplements, not drugs. The labels on these products don't tell you about their ingredients, risks, side effects, or possible harmful interactions with other substances. Nor do they guarantee that the herb is in a form your body can absorb or that the recommended dosage has been tested on animals or humans.

Also, herbal products may contain ingredients other than those indicated on the label. For example, Siberian ginseng capsules were found to contain a weed full of male hormone-like chemicals. What's more, the amount of active ingredient in an herb varies from brand to brand and possibly from bottle to bottle within a particular brand.

To help prevent problems caused by herbal medicine, follow these guidelines.

General precautions

* Check with your health care practitioner before using any herbal product especially if you're taking a prescription drug. Tell your practitioner about all drugs you're taking, including nonprescription medications and vitamins. Many herbal remedies can interact with other drugs.

* Make sure your health care practitioner is aware of your medical history, including allergies.

* When taking an herb, follow the instructions exactly. If you take too much of an herb or take it inappropriately, you may get no benefit from taking it -- or put yourself at risk for potentially dangerous side effects.

* Never ignore symptoms you're experiencing. Contact your health care practitioner if you experience side effects of an herbal agent or if you have other health concerns that would normally require medical attention.

* Be sure to call your health care practitioner if you experience abdominal cramping, abnormal bleeding or bruising, changes in your pulse or heart rhythm; vision changes, dizziness or fainting; hair loss; hallucinations, inability to concentrate or other mental changes, hives, itching, rash, or other allergic symptoms, appetite loss, or dramatic weight loss.

* Don't use herbal agents to delay seeking more appropriate therapy. Keep in mind that herbs aren't necessarily a substitute for proven medical therapy.

* If you're a parent or other caregiver, consider each of the preceding precautions before giving herbal medicines to a child or an elderly debilitated person.

* Discontinue herbs at least 2 weeks before before surgery. They can interfere
with anesthesia and cause heart and blood vessel problems.

When to avoid herbs

* Avoid herbal preparations if you're pregnant or breast-feeding. Most herbs' effects on the fetus are unknown. If you're a woman of childbearing age, use birth control when taking herbs.

* Don't use herbs for serious or potentially serious medical conditions, such as heart disease or bleeding disorders.

* Never let other people take your herbs or other medicine. Store herbal agents out of reach of children and pets.

* If you have questions about the herb you're taking, seek advice from a qualified health care provider. If your practitioner isn't knowledgeable about herbs, ask for a referral to someone who is.

Buying herbal products

* Be wary of products that promise to cure specific health problems.

* Read labels carefully when buying herbal products. Check for the term standardized on the label. Standardized means that the dose of medicine in each tablet or capsule in that package is the same. Also make sure the label states specific percentages, amounts, and strengths of ac...